Racial disparities in context: a multilevel analysis of neighborhood variations in poverty and excess mortality among black populations in Massachusetts

Am J Public Health. 2005 Feb;95(2):260-5. doi: 10.2105/AJPH.2003.034132.


Objectives: We analyzed neighborhood heterogeneity in associations among mortality, race/ethnicity, and area poverty.

Methods: We performed a multilevel statistical analysis of Massachusetts all-cause mortality data for the period 1989 through 1991 (n=142836 deaths), modeled as 79813 cells (deaths and denominators cross-tabulated by age, gender, and race/ethnicity) at level 1 nested within 5532 block groups at level 2 within 1307 census tracts (CTs) at level 3. We also characterized CTs by percentage of the population living below poverty level.

Results: Neighborhood variation in mortality across CTs and block groups was not accounted for by these areas' age, gender, and racial/ethnic composition. Neighborhood variation in mortality was much greater for the Black population than for the White population, largely because of CT-level variation in poverty rates.

Conclusions: Neighborhood heterogeneity in the relationship between mortality and race/ethnicity in Massachusetts is statistically significant and is closely related to CT-level variation in poverty.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • African Americans / statistics & numerical data*
  • Aged
  • Censuses
  • Child
  • Child, Preschool
  • European Continental Ancestry Group / statistics & numerical data
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Massachusetts / epidemiology
  • Middle Aged
  • Mortality / trends*
  • Poverty
  • Poverty Areas*
  • Residence Characteristics / classification
  • Residence Characteristics / statistics & numerical data*
  • Risk Factors
  • Socioeconomic Factors
  • Vulnerable Populations / classification
  • Vulnerable Populations / statistics & numerical data*